Individual
MARK RICCIONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP
Contact information
Practice address
6701 FANNIN ST, HOUSTON, TX 77030-2316
(832) 824-6230
(832) 825-6229
Mailing address
6701 FANNIN ST, HOUSTON, TX 77030-2316
(832) 824-6230
(832) 825-6229
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
707537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169784901
—
TX
Enumeration date
10/17/2006
Last updated
05/03/2013
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